According to LCD L36342, a diagnostic mammography is a radiologic procedure furnished to a man or woman with signs and symptoms of breast disease, personal history of breast cancer, or a personal history of biopsy-proven benign breast disease, and includes a physician’s interpretation of the results of the procedure. Diagnostic mammogram(s) are allowed ...

All radiology services require proper orders, identifying the diagnosis for which the imaging is being ordered. “Rule out” or “Possible” won’t work for reimbursement purposes because professional services cannot code unconfirmed diagnoses. As such, for those types of services, include the symptom(s) as the diagnosis for which you are seeking ...